Presentation
Low velocity MVC, hit chest on steering wheel.
Patient Data
Gender: Female
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Widened mediastinum.
Left apical cap.
From the case:
Thoracic aortic transection
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Small left pneumothorax with chest tube. Small right effusion.
Hemomediastinum.
Transection of the thoracic aorta near the isthmus with large pseudoaneurysm.
Case Discussion
Devastating injury which was not initially suspected as this patient was in a low-velocity MVC with few complaints of pain.
The tethering of the ligamentum arteriosum creates a point of relative fixation, and the patient likely had a deceleration/shearing injury occur in the isthmus, resulting in transection/rupture.